Rendered View very pixelated compared to Rendered Result
The issue appears to be the way that cycles handles small light sources.  To solve this I turned down the brightness for all of my small indoor lights and added a blender internal light (spot light) and placed them as if they were sourced from the bulbs (and parented the meshes to them for ease of adjustment) and adjusted the brightness from there.   This appears to give the realistic affect I was looking for.